On the Spotlight: Wegovy and its Implications for Buncombe County
Asheville – The recent talk of the town among the Buncombe County Commissioners was all about a weight loss drug known as Wegovy. In their last formal meeting, the commissioners spent a significant chunk of time discussing the implications of this medication, especially considering the county’s self-insured health plan and the need to be a good steward of taxpayer dollars.
A Punchy Price Tag
In the last eight months alone, Buncombe County has shelled out nearly $500,000 on Wegovy for about 108 employees who aren’t using it for treating diabetes but rather for weight loss. An additional $300,000 was spent on other related medications. That’s a hefty sum, and the county’s health claims are currently running $1.8 million or 4.6% over budget!
During the meeting, the county’s health benefit consultant, USI, suggested ideas to tackle this financial concern. Their recommendations included increasing premiums, raising the coinsurance rate, and potentially cutting back on coverage for GLP-1 medications like Wegovy that are primarily being used for weight loss.
Experts Weigh In
At the forefront of the discussion was Fredrick Manasseh, PharmD, who noted that there is a considerable buzz surrounding these drugs, largely thanks to celebrities and a flood of ads on television and social media platforms like TikTok. “It’s the new, latest, greatest thing, right? Better life through chemistry,” he quipped.
However, it’s not just about the hype. The appeal of Wegovy and similar drugs also comes with concerns about their safety and long-term effects. Research indicates that around one-third of patients prescribed these GLP-1 medications stop taking them due to adverse reactions. Additionally, many regain the weight once they stop, leading to serious questions about the sustainability of this weight loss solution.
Beyond the Weight Loss
Moreover, as Larry Reece from USI pointed out, these medications don’t just eliminate unwanted pounds; they can also lead to a reduction in bone density and deterioration of cartilage over time. “So what if someone’s consuming that for 20 years?” he asked the audience, illustrating the unknown long-term implications of such treatments.
Historically, Buncombe County has offered traditional weight loss medications that cost significantly less—around $100 for a month’s supply, compared to a whopping $1,349.02 for Wegovy. Unsurprisingly, almost nobody submitted claims for those less glamorous, established options.
Long-term Health Benefits vs. Immediate Costs
Commissioner Brownie Newman raised a valid point about the health benefits that weight loss can bring, particularly its potential to lower the risk of chronic diseases like type 2 diabetes and heart issues. In fact, just this past March, the FDA approved Wegovy for use in reducing the risk of heart attacks and strokes among those already at risk.
Newman expressed hope that the two-thirds of patients without negative reactions to the medication would provide more insight into its effectiveness in the long run. However, the representatives from USI were cautious, noting that investing in weight loss medications now could lead to an increase in healthcare costs overall due to the potential for new chronic diseases to arise.
Questions About Future Coverage
Another point of discussion was why there seemed to be such an intense focus on including a single drug in their coverage formulary. Reece highlighted that the emergence of GLP-1 medications for weight loss has sparked discussions at decision tables that haven’t occurred in his career before.
It’s worth noting that Blue Cross Blue Shield plans to cover these medications for fully-insured patients starting in 2025, but it will involve patients going through a rigorous process, including counseling and regular check-ups.
What’s Next?
As the conversation around Wegovy and its implications for the county continues, the commissioners plan to revisit this matter at their meeting on September 17. As healthcare evolves and new options emerge, it’s clear that decisions made today will shape the future well-being of the community and their healthcare expenditures.
